| NPI | 1871824185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME116108) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10034229) |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2016-07-29 |